Rommel A, Kottner J, Suhr R, Lahmann N
Abteilung 2: Epidemiologie und Gesundheitsmonitoring, Robert-Koch-Institut, Postfach 65 02 61, 13302, Berlin, Deutschland.
Klinik für Dermatologie, Venerologie und Allergologie, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
Z Gerontol Geriatr. 2019 Feb;52(1):3-9. doi: 10.1007/s00391-017-1215-5. Epub 2017 Mar 22.
Among the elderly falls frequently result in injuries, increase the need for long-term care and pose a challenge for the quality assurance in nursing care. We describe the frequency and risk factors of falls among care-dependent persons using home care services in Germany.
The participants of the study "Nursing-related health problems in home care" (n = 880) were recruited based on a list of the officially accredited nursing services. Data collection followed a standardized study protocol. Proportions were calculated and adjusted odds ratios and predicted probabilities were estimated using binary logistic regression.
Falls are a frequent occurrence among care-dependent persons who are cared for by home care services: Almost every tenth care-dependent person suffers from a fall within a period of 2 weeks. Falls are mainly associated with social and care-related factors. Besides a low educational status this comprises certain living and care arrangements: People living alone or having infrequent contact to their nursing service as well as clients that, according to their carers, should receive more support have a significantly higher chance of falling. Multimorbidity is a medical risk factor while neurological diseases as well as polypharmacy present increased risks only in interaction with living and care arrangements.
Nursing staff and physicians should maintain an overview of the social and health conditions of people in need of long-term care. If care-dependent persons live alone or are infrequently cared for, additional medical problems considerably increase the risk for falling; therefore, preventive interventions and follow-up assessments of actual need levels should be promptly considered if health conditions or living arrangements change.
在老年人中，跌倒常常导致受伤，增加了长期护理的需求，并对护理质量保证构成挑战。我们描述了在德国使用家庭护理服务的依赖护理者的跌倒频率和风险因素。
“家庭护理中与护理相关的健康问题”研究（n = 880）的参与者是根据官方认可的护理服务名单招募的。数据收集遵循标准化的研究方案。计算比例，并使用二元逻辑回归估计调整后的优势比和预测概率。
在接受家庭护理服务的依赖护理者中，跌倒是常有的事：几乎每十个依赖护理者中就有一个在两周内跌倒。跌倒主要与社会和护理相关因素有关。除了低教育水平外，还包括某些生活和护理安排：独居或与护理服务接触不频繁的人，以及据其护理人员称应获得更多支持的客户，跌倒的可能性明显更高。多种疾病是一个医学风险因素，而神经疾病以及多种药物治疗仅在与生活和护理安排相互作用时才会增加风险。
护理人员和医生应全面了解长期护理需求者的社会和健康状况。如果依赖护理者独居或护理不频繁，其他医疗问题会大大增加跌倒风险；因此，如果健康状况或生活安排发生变化，应及时考虑预防性干预措施和对实际需求水平的后续评估。
